Radiologic examination, spine, lumbosacral; 2 or 3 views

CPT 72100 is the billing code for "Radiologic examination, spine, lumbosacral; 2 or 3 views". For lumbosacral spine X-ray with 2 or 3 views

Medicare pays approximately $38.49 for CPT 72100 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 72100 has a total RVU of 2.30, broken down as: Work RVU 0.45, Practice Expense RVU 1.80, and Malpractice RVU 0.05. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 72100 include: Indication for lumbosacral spine X-ray; 2 or 3 views obtained; Findings and interpretation; Alignment assessment. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 72100: Includes 2 or 3 views lumbosacral spine. Includes interpretation and report Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 72100 include: 26 (Professional component only (interpretation)), TC (Technical component only (equipment/staff)), 59 (Distinct procedural service if performed separately). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 72100 is 8-12 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.